Active NPI
Charlene Kimberly Pasaoa Fernandez
- Pharmacist
- New York, NY
National Provider Identifier
1629595277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 063195
- Practice address
- 1569 1St Ave
New York, NY 10028-4003 - Phone
- (212) 249-5198
- NPI assigned
- Aug 24, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 063195 | NY | Primary |
Addresses
Primary practice location
1569 1St Ave
New York, NY 10028-4003
Mailing address
8000 Utopia Pkwy
Jamaica, NY 11439-9000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 063195 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CVS Albany LLC | Past | Accepting new patients | |
| CVS Albany LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pharmacy
- New York, NY
- NPI 1922102763
-
- Pharmacy
- Brooklyn, RI
- NPI 1679459481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503532800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1629595277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8000 UTOPIA PKWY",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114399000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1569 1ST AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100284003",
"telephone_number": "212-249-5198"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDEZ",
"first_name": "CHARLENE",
"middle_name": "KIMBERLY PASAOA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-24",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "063195",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.